Provider Enrollment Quality Assurance

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. 

Summary

​As a Provider Enrollment Quality Assurance at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.
 

Your role in our mission

• Performs complex standard and non-standard processing and quality tasks in support of outsourced services within a specific industry and functional area. Demonstrates knowledge and skills in a variety of assigned work processes.
• Understands the business of the client and related market dynamics; applies knowledge to ensure best practice procedures and continuous process improvement. Identifiies issues and reviews, recommends and implements modifications to procedures and workflow as necessary to ensure efficient and effective processing of transactions.
• Performs analyses and reports findings. Interprets, audits and reconciles reports for accuracy or completeness. Maintains log records of pertinent data and provides periodic status reports. Prepares standard and adhoc reports for management and clients.
• Researches problems and follows up with the client regarding resolution. Interfaces with management and clients to resolve issues and assists in implementing same as approved.
• Supports development and documentation of new or revised standard operating procedures.
• Handles company confidential data according to policy and guidelines. Adheres to existing security policies and procedures.
• May provide leadership and work guidance to less experienced personnel. Trains and assists team members. Monitors daily activity of employees to ensure policy and procedures are being followed. Coordinates with managers and employees to ensure adequate scheduling. Prioritizes and delegates work.

What we're looking for

• High school diploma or GED required.
• Minimum of 2 years of experience in provider enrollment, healthcare operations, or quality assurance.
• Proficiency in provider enrollment systems and claims processing platforms.
• Strong proficiency in Microsoft Office Suite, particularly Excel (e.g., pivot tables, formulas) for data analysis and reporting.
• Awareness of healthcare compliance standards and regulatory guidelines (e.g., CMS, state, and federal regulations).
• Harver Assessment Requirement: As part of our interview process, all candidates must complete the Harver Assessment. This assessment helps us evaluate key competencies relevant to the role, including communication skills, multitasking abilities, and problem-solving capabilities.

What you should expect in this role

• This is a remote position with a Monday through Friday schedule, from 8:00 AM to 5:00 PM.
• Video cameras must be used during all interviews, as well as during the initial week of orientation.
• To work effectively as a teleworker with Gainwell, employees must have a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload. Higher speeds are recommended for optimal performance.
• To Test your internet download and upload speed:
  • Go to Google.
  • Search for Internet Speed Test or click here.

#LI-REMOTE #LI-JA1 #LI-CM1
 

The pay range for this position is $39,100.00 - $55,900.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.